Hi all,
Hope you've enjoyed the series thus far.  If you missed any pieces of the series, please review the archive section.  New posts will be written on weekly basis, typically premiering at the end of the week.  The next installment of this dialogue focuses on taking an emotional approach that helps the person with Autism feel more comfortable.

When trying to connect with another person, it’s not just connecting with words but with emotions as well.  The same is true for connecting to people with Autism.  The difference is, however, that the emotional approach is not the same.  For example, while a bright energetic approach may be attractive for many people it is typically not attractive to people with Autism and those with sensory sensitivities.  In fact, this level of excitement, especially from an unfamiliar person, could be quite overwhelming and aversive.  Anxiety is already high in these instances and the high excitement level often makes the situation unbearable.  So, instead of trying to be a reinforcing or engaging presence, this type of approach seems to have the opposite effect.  As parents and educators, the natural tendency is to show our excitement when our children and students do well, but any person would not want to perform well when the consequence of that performance causes sensory overstimulation.  Therefore, when approaching a person with Autism it is best to take a calm approach.  Shows as little affect as possible during the initial stages and then gradually increase your emotional expression as the person with Autism becomes more comfortable with you.  Don’t assume that if the person with an Autism shows more affect that it is a cue for you to show more emotion.  People with Autism are often better at giving sensory stimulation to others rather than receiving it because they can control the level of stimulation they will be experiencing and are prepared to experience it.  When receiving stimulation, the receiver is typically unaware of the amount of stimulation they will be receiving and may not be prepared to accept it.  

Steven C. Altabet, Ph.D.

The next installment of this dialogue continues to focus on communication with an emphasis on preparing the listener.The final communication aspect to be discussed is preparation.  What is meant by preparation is that people with Autism typically like to know what to expect and become flustered with change that is not anticipated.  This goes back to the assertion that people with Autism have difficulty shifting their thoughts quickly.  This appears true for conversation topics as well as activities.  When wanting to change the topic, let the person with Autism know the intent to do so.  Qualifiers such as “Speaking of ….” Or “that reminds me of …” can be used, or simply stating that you’d like to talk about something else will also work.  When a person with an Autism wants to change the subject they may impulsively blurt out the new topic.  If they do this, it is ok to acknowledge that the individual would like the topic changed, but then show them how to change the topic more appropriately before proceeding.  Also, they may need to be reminded to allow the speaker to finish their thought before they can speak.  The other type of preparation that is important for conversation is preparation for ending the encounter.  In addition to warning the person that the conversation needs to end, tell them why this needs to happen.  They’ll likely want to say one last final thought for closure.  Frequently, when the person with an Autism wants to end a conversation they typically just stop talking.  Sometimes, however, the pause is just for the person to collect their thoughts and continue speaking.  When you hear an extended silence it is ok to ask “do you have any more you wish to say?” if they say “no” then you would want to model appropriate conversation enders like “good bye,” “see you later,” “and it was nice talking to you.” 

Hi all,

This is a continuation of a series I started with my last post focusing  on how to better connect with individuals diagnosed with an Autism Spectrum Disorder.   For the purpose of these posts I am referring to individuals on all levels of the Autism Spectrum with the term 'Autism.'  The previous posted emphasized communicating in a direct form and not becoming offended when that direct form of communication is given to you.    


This weeks recommendation for communication is succinctness.  People with Autism tend to only be able to process a few words at a time, so long monologues and lectures tend to go misunderstood.  After the first few words, the person’s thoughts are likely to go somewhere else like “When can I leave this long conversation and tend to my personal interests?”  If they are truly interested in being part of the conversation they may be thinking of what to say next instead of taking in everything that you are saying to them.  Keeping messages short and to the point will helpful them be understood better.  If there is much to be said, then break it up into many smaller segments.  When it comes to expression, people with Autism will typically speak to you in a very succinct manner, unless it is about a preferred topic, then the person will likely respond in a wave of details.       

When dealing with literal thinkers, you want to be very specific with what you say.  People with Autism often misinterpret generalities due to poor ability to inference.  Therefore, when trying to get a specific message across say it exactly the way it was meant to be interpreted.  Try to phrase questions in a way that results in either a yes/no answer or can be answered in a short phrase or sentence.  Open ended questions will typically result in blank stares or awkward pauses, while the person tries to figure out what was meant or how to answer the question.  If the listener appears hesitant offer some options for possible responses.  For example, if you ask “What do you want to do today?” and you get a blank stare or “I don’t know,” you could suggest a couple of activities for the person to choose.  If making a choice is too difficult, suggest a specific activity and they could answer “yes” or ‘no.” 
 
Sometimes you may have to use visual supports to further explain or demonstrate what is being conveyed.  Visual supports can be any type of item or action that helps the person with Autism see what is being explained to them.  Examples of these include pictures, charts, diagrams, gestures, modeling, and physical demonstration.  If a picture is worth 1,000 words to a typical person, it is worth 10,000 words to a person with Autism.   Conversely, if a person with an ASC is having difficulty explaining what they mean, instead of trying to have them say it differently or guessing at what they meant, have them draw or act out what they are trying to convey.  Even with the visual supports there will still be times when there is uncertainty over what has been stated or received.  While most of us may ask for clarification when we are unsure of a message, many people with Autism typically ask very few questions.  They may simply guess at the meaning rather than asking “What did you mean by that?”  Therefore, it important to make sure the person with Autism knows your intention.  If most people with Autism are asked if they understood what was just said, they will be honest enough to report if they did not understand.  For those who are less willing to admit this, it will not offend the person if they are asked what they believed the message meant.  Also, person with Autism’s message may not always be clear, especially if they are using any type of jargon or slang.

As always, I welcome and comments or questions.

Steven C. Altabet, Ph.D.  

I'm writing this next post for what I hope to become a series of interactive discussion regarding how to better connect with people on the Autism Spectrum.  Over the next several weeks I plan to post different strategies for making better connections.  Some of the techniques have come form research studies, but most have come either from observations of my assessment or therapy clients or directly from comments made by individuals with ASD.  As mentioned in the title this is intended to be a dialogue, so feel free to comment and share your ideas.  I'd like to start with a communication strategy and proceed from there.

Steven C. Altabet, Ph.D.

Style of Communication

One of the keys to connecting to a person with Autism is to communicate with them in a manner that is consistent with the way they think and express themselves.  In particular, people with Autism typically like to communicate directly and better understand what is being said when it is delivered in a direct manner.  While many people like to convey what they mean without saying it directly, this type of language is often lost on a person with Autism.  In fact, many times metaphorical language is misinterpreted to the literal meaning rather than its intent.  In other words, if you want people with Autism to understand you, ‘mean what you say and say what you mean.’   Most people avoid speaking so directly in order to avoid offending the listener.  While this may be true for most listeners, the person with Autism would likely appreciate the directness with which you are speaking.  In addition when someone with Autism speaks to you, they are most likely not trying to be rude when speaking in this direct manner.  That is just the way they prefer to communicate.  After you have gained the person’s trust it may be ok to point out that what they just said may be perceived as rude, but there is no reason to be offended by it, because there was no intent to be offensive.  If a person with an ASC wanted to offend you they would let you know. 

It is the start of a new year and this is my initial post so I am writing with a sense of excitement and curiosity. Will people connect to this piece?  What impact will it have?  There could be many more of these questions if I allow them to persist, but I am able to quiet my mind and keep the questions from taking up too much of my thought.  That is not necessarily true for people with Autism.

My practice as a clinical psychologist has been exclusively with individuals with Autism Spectrum Disorders (ASD's) for the past 5 years and it had comprised the majority of my practice since 2004.  During this time I have learned a great deal about evaluating and treating people with ASD's and in the process they have taught me many lessons as well. In these blogs I plan to share some of my experiences and insights while hopefully receiving further insights and knowledge from others.    

Since this is the start of a new year as well as my adventures in blogging I'd like to discuss how people with ASD's experience something new.  While a new experience can be a source of joy and excitement for many people it is typically an anxiety ridden experience for people with ASD's.  The is because the nervous system of someone with ASD is so sensitive, that they can typically only process a small amount of new information or excitement at one time.  Over the course of these blogs I'll try to outline the neurological processes behind the decision making and reactions of people with ASD, but for now let's just say that new experiences are often overwhelming and met with some type of resistance or escape response.

Does that mean that people with ASD should never be exposed to new experiences?  The short answer is "no", because new experiences are how we grow and develop over time.  There are two keys for helping a person with ASD enjoy and benefit from new experiences.  The first is to prepare them for the new experience.  People with ASD typically react much better to experiences when prior warning and explanation is given.  This could be as simple as pictures and demonstrations or as elaborate as detailed verbal explanations or diagrams for those with greater vocabularies and cognitive abilities.  For example I've worked with individuals who had severe intellectual disability as well as Autism and they were able to show greater cooperation at the dentist when allowed to participate in simulated dental appointments prior to their cleaning.  

The other important aspect of providing new information or experiences is that it is done slowly and gradually.  Allow the person with ASD to absorb  a small amount of the new information until they are comfortable, then continue to provide the information in small increments.  To use the analogy of a swimming pool, jumping straight into a cold pool without first putting your foot in the water results in quite a shock to your body, where as taking the steps and wading into the pool allows your body to slowly get used to the temperature change.  While some people like that sudden shock to the system most people with Autism do not like that feeling.  In fact, they often dislike that feeling so much that they try very hard to never have that experience again.  

I hope you will find these tips to be helpful.  I plan to provide more of these tips on a regular basis.  Please feel free to comment and respond if you wish for more information or clarification about a particular topic.